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目的:研究表现为非神经源性膀胱外括约肌协同失调(NNDSD)的慢性前列腺炎(CP)的特点及其生物反馈治疗疗效。方法:CP患者113例,诊断标准为有尿频、尿急、尿痛、排尿不尽、排尿困难等CP的典型症状大于3个月,且NIH-CPSI评分中第一和第二项评分≥1。经相关检查,排除尿道炎、间质性膀胱炎、尿道狭窄和神经源性膀胱等情况。113例均行尿动力学检查,分析尿流曲线,记录最大尿流率(Qmax)、最大逼尿肌排尿压(Pdet.max)、最大尿道压(MUP)和最大尿道闭合压(MUCP)等参数。对尿流动力学结果表现为NNDSD的患者行生物反馈治疗,10周后评估疗效。结果:CP患者113例中尿流动力学表现为NNDSD的21例(21/113,18.6%)。NNDSD患者治疗前后Qmax[(8.2±4.1)ml/s vs(15.1±7.3)ml/s]、Pdet.max[(125.1±75.3)cmH_2O vs(86.3±54.2)cmH_2O]、MUP[(124.3±23.3)cmH_2O vs(65.4±23.0)cmH_2O]和MUCP[(101.5±43.6)cmH_2O vs(43.5±16.7)cmH_2O]差异有统计学意义(P<0.05);生物反馈治疗前后NIH-CPSI疼痛评分[(4.0±2.0)分vs(2.2±1.7)分]、排尿评分[(7.9±2.1)分vs(2.2±1.9)分]、生活影响评分[(9.6±2.7)分vs(2.9±2.6)分]和总分[(21.7±4.8)分vs(8.4±4.6)分]差异有统计学意义(P<0.05)。结论:有下尿路症状的CP患者可能存在NNDSD,尿动力学主要表现为尿流率下降,排尿期膀胱内压力升高和部分患者尿道压力升高,尿动力学检查可以明确诊断及选择正确的治疗方法;盆底肌生物反馈治疗此类患者的近期疗效确切。
Objective: To investigate the characteristics of chronic prostatitis (CP) manifested as non-neurogenic bladder sphincterosis (NNDSD) and its biofeedback therapeutic efficacy. Methods: One hundred and thirteen patients with CP were diagnosed as having typical symptoms of CP with urinary frequency, urinary urgency, dysuria, urination, dysuria, etc. for more than 3 months. The first and second scores of NIH-CPSI score ≥1 . After the relevant inspection, exclude urethritis, interstitial cystitis, urethral stricture and neurogenic bladder and so on. All 113 patients underwent urodynamic examination. Urinary flow curves were recorded and the maximum flow rate (Qmax), maximum detrusor pressure (Pdet.max), maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) were recorded parameter. Biofeedback was performed on patients with NNDSD urodynamics and 10 weeks later. Results: Of the 113 patients with CP, 21 had urodynamics (21 of 113, 18.6%) with NNDSD. Qmax [(8.2 ± 4.1) ml / s vs (15.1 ± 7.3) ml / s], Pdet.max [(125.1 ± 75.3) cmH_2O vs (86.3 ± 54.2) cmH_2O], MUP [124.3 ± 23.3 (P <0.05). The NIH-CPSI pain scores before and after biofeedback treatment (4.0 (4.0) vs (65.4 ± 23.0) cmH2O and MUCP (101.5 ± 43.6) cmH2O vs (43.5 ± 16.7) cmH2O, respectively] ± 2.0) vs 2.2 ± 1.7), urinary score (7.9 ± 2.1) vs (2.2 ± 1.9), life impact score [(9.6 ± 2.7) vs (2.9 ± 2.6) The total score [(21.7 ± 4.8) vs (8.4 ± 4.6) points was statistically significant difference (P <0.05). Conclusion: There may be NNDSD in CP patients with symptoms of lower urinary tract. The main manifestations of urodynamics are decreased urinary flow rate, increased intravesical pressure during voiding period and elevated urinary tract pressure in some patients. Urodynamic examination can confirm the diagnosis and correct selection Of the treatment; pelvic floor biofeedback treatment of such patients the exact effect of the recent.